OBJECTIVE: Improved means to monitor and guide interventions could be useful in
the intensive care unit. Metabolomic analysis with bioinformatics is used to
understand mechanisms and identify biomarkers of disease development and
progression. This pilot study evaluated plasma proton nuclear magnetic resonance
spectroscopy as a means to monitor metabolism following albumin administration in
acute lung injury patients.
DESIGN: This study was conducted on plasma samples from six albumin-treated and
six saline-treated patients from a larger double-blind trial. The albumin group
was administered 25 g of 25% human albumin in 0.9% saline every 8 hrs for a total
of nine doses over 72 hrs. A 0.9% concentration of saline was used as a placebo.
Blood samples were collected immediately before, 1 hr after, and 4 hrs after the
albumin/saline administration for the first, fourth, and seventh doses (first
dose of each day for 3 days). Samples were analyzed by proton nuclear magnetic
resonance spectroscopy, and spectra were analyzed by principal component analysis
and biostatistical methods.
INTERVENTIONS: None.
MEASUREMENTS AND MAIN RESULTS: After 1 day of albumin therapy, changes in small
molecules, including amino acids and plasma lipids, were evident with principal
component analysis. Differences remained 3 days after the last albumin
administration. Analysis of data along with spectra from healthy controls showed
that spectra for patients receiving albumin had a trajectory toward the spectra
observed for healthy individuals while those of the placebo controls did not.
CONCLUSION: The data suggest that metabolic changes detected by proton nuclear
magnetic resonance spectroscopy and the bioinformatics tool may be a useful
approach to clinical research, especially in acute lung injury.